Bacterial Keratitis Follow-up

Updated: May 03, 2017
  • Author: Jean Deschênes, MD, FRCSC; Chief Editor: Hampton Roy, Sr, MD  more...
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Follow-up

Further Outpatient Care

Patients with bacterial keratitis need to be monitored closely to make certain the infection is responding to treatment as the medications are tapered.

Severe cases of bacterial keratitis are monitored daily, while-less severe cases may be monitored every few days.

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Further Inpatient Care

The frequency of antibiotic administration should be tapered off gradually according to the clinical improvement using some of the following parameters:

  • Blunting of the perimeter of the stromal infiltrate

  • Decreased density of the stromal infiltrate

  • Decreased stromal edema and endothelial inflammatory plaque

  • Decreased anterior chamber inflammation and reepithelialization of the corneal epithelial defect

Improvement of patient's symptoms

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Inpatient & Outpatient Medications

The antibiotic medications are decreased slowly, depending on the culture and sensitivity results and the clinical response. If topical steroids are used, the antibiotic should not be discontinued.

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Deterrence/Prevention

Topical antibiotics are given routinely after traumatic injury to the cornea (including surgery).

Preventing contamination of topical medications and the use of sterile contact lens solutions are critical steps in preventing contact lens-related infections.

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Complications

The most feared complication of this condition is thinning of the cornea, secondary descemetocele, and eventual perforation of the cornea that may result in endophthalmitis and loss of the eye.

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Prognosis

The visual prognosis depends on several factors, as outlined below, and may result in a mild-to-severe decrease in best-corrected visual acuity.

  • Virulence of the organism responsible for the keratitis

  • Extent and location of the corneal ulcer

  • Resulting vascularization and/or collagen deposition

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Patient Education

Patients who are contact lens wearers (in particular extended-wear contact lenses) should be instructed not to force the use of contact lenses when they have hyperemia, irritation, or foreign body sensation, and to use sterile contact lens solutions to avoid contamination.

For excellent patient education resources, visit eMedicineHealth's Eye and Vision Center. Also, see eMedicineHealth's patient education article Corneal Ulcer.

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